Provider Demographics
NPI:1043823693
Name:LOOKABAUGH, TYLER JACK (PT)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:JACK
Last Name:LOOKABAUGH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 STATE ROUTE 380
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-2200
Mailing Address - Country:US
Mailing Address - Phone:724-681-1239
Mailing Address - Fax:
Practice Address - Street 1:850 WALNUT BOTTOM RD STE 306
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-3615
Practice Address - Country:US
Practice Address - Phone:717-241-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-24
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist